MUDDAMALLE J AUGUSTINE MD PA
Ambulatory Health in Arlington, TX

License number
Texas G6261
Category
Ambulatory Health
Type
Primary Care
Owner
Name: MUDDAMALLE J AUGUSTINE MD
Title: PRESIDENT
Phone: (817) 861-6464
Address
Address
912 Wright St Suite E, Arlington, TX 76012
National Provider ID: 1497022834
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MUDDAMALLE J. AUGUSTINE, M.D., PA

912 Wright St STE E, Arlington, TX 76012

Registration:
Apr 16, 1984
State ID:
0080957003
Business type:
Professional Association
President , Director, Member:
M. J. Augustine (President , Director, Member)
Agent:
Muddamalle J. Augustine,912 Wright St, Arlington, TX 76012 (Physical)
TIN:
32036039165

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